10

expenditure, the excess energy is converted to body fat and gain weight. On the other

hand, if the intake is less than the expenditure, the body uses up fat stores and lose

weight. Therefore, for weight to remain stable, the total amount of calories that are

consumed must not surpass the total that is used up through metabolic processes

(exercising, sweating, and breathing). Energy intake must match energy output. The

average energy intake is about 2800 kcal/day for men and 1800 kcal/day for women,

although this varies with body size and activity level.

Nutritional Problems

The effects from poor nutrition are seemingly endless. It generally results in

considerable weight gain, which puts a person at risk for a myriad of health problems,

whether physical, mental or emotional. Taking charge of your health will not only protect

you from health problems as you age, but will also give you more energy and peace of

mind. A healthy life requires proper nutrition as well as regular exercise. Both are key in

the prevention of disease and also help improve overall mental and physical health. Diets

full of bad fats, such as trans and saturated fats, put you at risk for stroke, certain cancers

and heart disease, whereas a diet rich in vegetables lowers the risk of prostate and breast

cancer, among other benefits.

Sugar, bad fats and processed foods also increase your risk for joint problems,

such as arthritis, which is compounded by a lack of exercise, as regular workouts keep

the body limber and loose. A healthy diet should be high in vegetables, fruits, cold water

fish and whole grains, while exercise should include cardiovascular and strength-training

workouts
 11

Obesity is an effect of lack of exercise in combination with a poor diet high in

saturated fats, simple carbohydrates and sugar. It puts risk for numerous health issues,

including breathing problems, diabetes, trouble sleeping, high blood pressure and

increased heart disease risk. It can also lead to low self-esteem and depression. Though

genetic factors can play a part, a regular exercise routine coupled with healthy eating

habits will keep the weight off.

Illnesses and Conditions like secondary hypertension, or high blood pressure, is

one of the numerous conditions that can arise from being overweight. Secondary refers to

hypertension occurring due to another health condition. The arteries become clogged and

hardened due to a poor diet and lack of exercise, as both are required to keep the arteries

flexible and free from unwanted substances. Hypertension puts you at risk for stroke,

kidney failure and heart disease, according to Mayo Clinic findings. Another health issue

that is often the result of poor diet and lack of physical activity is diabetes. Diabetes

usually occurs when the body fails to produce enough insulin, and Type 2 diabetes often

results from an inactive lifestyle compounded by a poor diet, according to the American

Academy of Child and Adolescent Psychiatry. Those with hypertension are also at risk

for diabetes.

Diets rich in vitamins C, B, E, D and omega-3 fatty acids are recommended for

optimal brain health, whereas a diet high in trans fats can make the brain age faster,

according to Oregon Health & Science University's Dr. Gene Bowman, who has studied

the effects of trans fat on the brain. Diets high in sugar are especially toxic, as sugar can

deplete the amount of vitamin E in the blood and interfere with the body's mineral
 12

content, according to Dr. Nancy Appleton. A high-sugar diet can, in turn, make you feel

sleepy, irritable or unable to concentrate.

A 2012 UCLA study on the effects of sugar demonstrated how sugar affects the

brain's memory and learning ability, however a diet high in omega-3 fatty acids will

protect the brain from such effects. Physical activity will also keep the brain young, as it

increases blood flow to the brain. Walking, for example, literally oxygenates the brain as

breathing and heart rate increase, which improves blood circulation to the brain and rest

of the body. New studies by Justin S. Rhodes, a professor of psychology at the Beckman

Institute for Advanced Science and Technology at the University of Illinois, have also

indicated that exercise helps the brain reduce physical shrinkage and enhances cognitive

flexibility.

Magnitude of NCDs Related to Poor Dietary Practices

The World Health Organization estimates that 26,500 people are killed by NCDs

daily in the Western Pacific Region. This translates to 7 out of every 10 deaths in the

Region due to NCDs. More significant is the fact that close to half of deaths occurs in

people who are in their productive years. The Philippines is one of the 23 selected

countries contributing to around 80% of the total mortality burden attributable to chronic

diseases in developing countries, and 50% of the total disease burden caused by NCDs

worldwide. Global and local data show that the major NCDs – cardiovascular diseases,

cancers, diabetes mellitus and chronic obstructive pulmonary diseases are linked by four

common preventable risk factors related to lifestyle, namely: tobacco use, unhealthy diet,

physical inactivity and alcohol use.

 13

Nutrition and College Students

With a limited budget and 24/7 access to fast food and snacks, college students can

face big challenges while trying to eat right. Learning how to cook is one of the best

things that college kids can do for their health. Students are less likely to go out to eat

during the week if they have planned several nutritious meals in advance, and having the

skills needed to put together a meal can be useful for years to come and will help you stay

fit in the long run. It’s also important to keep a variety of healthy snacks on hand. Eating

raw veggies, fruits, and nuts between meals will give you the energy you need to tackle

those study sessions

Roles and Functions of a Nurse in Nutrition

What exactly does a nurse do? The answer probably depends on the experiences that

have occurred in the past. Most people think a nurse is someone who gives a shot at the

doctor's office or simply is a doctor's assistant. Furthermore, images of nurses in the

media also paint a different picture of who a nurse really is. However, a nurse has a

number of roles that he or she performs, often at the same time, depending on a patient's

needs. Preventive and whole-body educations are vital to a nurse's role, which can range

from care provider to teacher. An understanding of nutrition and healthy food choices for

patients is a vital part of a nurse's career because giving valuable health advice can help a

nurse promote wellness. With all of the changes in healthcare over the last few decades,

that role has expanded even more. Nurses wear many hats -- and not just the classic

folded-up white ones.

 14

Education is the key factor in enabling nurses to instigate nutritional care

appropriately. Nursing students need be educated in the screening and assessment,

planning, implementation and evaluation of nutritional care. A firm grounding in the

principles of nutritional science is essential to understand the rationale behind the

components of nutritional care.

Nutrition is Covered but Not Emphasized in Nursing

Most nurses take at least one course in basic nutrition during their studies. While

the specific requirements of nursing programs differ from place to place, nutrition is not

usually emphasized. Students pursuing a nursing degree are required to take many

diverse courses. These include subjects such as English, sociology, chemistry, biology

and many others. A nutrition course is usually part of this curriculum. The fact is,

however, that this field is actually far more important to the careers and personal well-

being of nurses than current educational policies reflects.

This situation is not unique to nursing, as even medical doctors may obtain their

degrees after having only a brief exposure to the field of nutrition. This reflects a

traditional gulf in modern medicine, where the focus tends to be on treating medical

conditions with medications and procedures. Nutrition has often been associated with

alternative or holistic medicine, where the focus is more on prevention. There are signs,

however, that this rift is gradually disappearing. As more and more evidence points to the

connection between nutrition, diet and health, hopefully the entire medical community

will soon see that this is something that both doctors and nurses should study in depth.
 15

Speaking about nurses in particular, there are two main reasons why nutrition is

extremely important.

Well Being of Nurses is Supported by Nutrition

The reason why nurses should be well informed about nutrition is for their own

health and well-being. Nursing is a demanding and often stressful career. Hours can be

long, and nurses often have to work a variety of shifts. Furthermore, they are often in the

company of people who are ill, which can take a toll on one’s immune system. In order to

perform their jobs optimally, people in demanding nursing jobs must first maintain their

own health. Nutrition is an excellent starting point for doing this. There is increasing

evidence that diet and nutrition are crucial when it comes to preventing and managing

illnesses. While nurses may not usually have an extensive background in nutrition, they

can remedy this by doing personal study as well as by taking courses in nutrition. They

might do this my choosing such courses as electives. There are also people with formal

training in the field of nutrition who may decide to become nurses. They are in the best

position of all, as they will be able to combine the knowledge from the disciplines of

nursing and nutrition.

Dietitians and nutritionists are taught a wide variety of principles regarding the

role of nutrition in health. This refers to formal requirements, of course. On their own,

some nurses may be very knowledgeable about nutrition. There are even nurses who also

have background in the field of nutrition. This does not, however, apply to nurses in

general. Apart from how useful nutritional information is for their careers, it can also help
 16

individual nurses maintain good health and a strong immune system. This can help them

cope with the long hours and pressures of the job.

While this could be beneficial to anyone, it’s of particular importance to people who

don’t have the luxury of working predictable schedules or sitting behind a desk all day.

While it might seem natural that people in a medical profession would take good care of

themselves, this is often not the case. Due to the pressures of their jobs, nurses often

neglect good nutrition and may suffer the consequences if they do this for extended

periods.

Nursing and Nutrition Works Hand in Hand

As mentioned, there has traditionally been a separation between the fields of

nursing and nutrition. This reflects a wider gulf between the entire medical field and

nutrition. Hopefully, as more research supports the importance of nutrition as a way to

prevent and manage illness, this will soon change.

There are several ways that this situation could be improved at an institutional

level. More nutrition courses could be required to obtain a nursing degree. Joint nursing-

nutritionist positions could be created. There would be a strong demand for such careers

at hospitals and nursing homes.

Both doctors and nurses should be encouraged to provide nutritional advice to

patients. While these developments would be welcome, nurses do not have to wait for

them to occur to start including the principles of nutrition into their personal lives and

careers. Nurses who have some background in nutrition can begin by applying their
 17

knowledge to their own lives. This can help them maintain good health and high energy

levels.

Furthermore, nurses can apply their nutritional knowledge by advising patients

when it is deemed appropriate. This can be a tricky area, as nurses must comply with the

rules and protocols of their employers. For this reason, it is advisable for nurses to

discuss these matters with their supervisors to ensure that this type of approach is

acceptable. Whether or not nurses are permitted to dispense nutritional advice will

depend on the particular rules and outlooks of the people or institutions for whom they

work. For example, many physicians and hospitals are open to educating patients on diet

and nutrition, while others may be more conservative and discourage nurses from

engaging in this type of action. Regardless of whether or not nurses are able to freely

dispense nutritional advice to patients, there is nothing to stop them from increasing their

knowledge in this area. This can still help them maintain their own health and well-being,

which is in itself of great value.

Nurses can be more Productive and Effective by Accumulating Nutritional Knowledge

Nursing jobs, along with many positions in the medical field, are among the

fastest growing careers of the 21st century. As the population ages and society deals with

challenges such as widespread obesity, it seems likely that new ways to prevent and

manage health conditions will be needed. Nutrition can play a significant role in this, and

a nurse is in the perfect position to help patients learn more about nutrition. Maybe in the

near future, obtaining a nursing degree will entail learning a great deal about nutrition.

This certainly seems rational. Until that type, all nurses can do is educate themselves
 18

regarding nutrition and apply this knowledge as best they can, both in their own lives and

in the course of their careers.

RELATED STUDIES

In this study, the researchers want to widen information about nutrition and its

importance and effects in the workforce. Personalities from both from foreign and local

contribute a study with this kind of topic. It analyzes the effects of nutrition

Lucy Wanja Kinyua, with her study focusing on nutrition knowledge and attitude

with dietary practices and nutritional status, most of the students have normal nutrition

status and the prevalence for overweight and/or obese is slightly more in Humanities and

Social Science students than in Science students. Dietary practices of the students are not

optimal. The students’ meal patterns are inadequate and food choices characterized by

highly refined cereal products, high sugar and fat products compared to healthier food

choices. Students contradicted themselves in practices despite exhibiting average

nutritional knowledge and positive attitude towards nutrition.

In the study conducted by Katie J. James on the eating routine and dietary habits

and it was concluded that the overall nutritional status of the respondents was

satisfactory. Most of the respondents had a good health and did not suffer from any kind

of illness. These respondents also had a normal level of hemoglobin and most of them

had normal range of BMI and the assessment of the clinical examination revealed that

majority of the respondents did not show any sign of deficiency. Moreover, the intake of
 19

food stuff by most of the respondents was quite satisfactory, even though they had a habit

of skipping the meals.

Mohammad Azizi and his other co researchers showed that the mean values and

standard deviation for age, height, weight and the Body Mass Index (BMI) of the

participants. The results show that the knowledge level of the nursing discipline with a

grade of 60.08 out of 100 is by a large margin the highest compared to the other

disciplines. Business Administration with a grade of 46.73 out of 100 is the lowest.

Using the one-way ANOVA, it transpired that there was a significant difference

in the knowledge level between students of different disciplines. In addition, the

knowledge level of the male participants (55.76 out of 100) was significantly higher than

that of the female participants (53 out of 100). It also showed that there is a significant

difference in the nutrition attitude between the different disciplines.

Sameer Deshpande and his other co researchers on factors influencing healthy

eating habits, shows that the influence of gender, dietary status, importance of a healthy

diet, food features, and cues to action on the intention to eat healthy in our study was

similar to their study. Despite similarities with earlier research this study found no

significant effects of the food features such as price, taste, ease of preparation, and

convenience on barriers, efficacy, and thus the likelihood to eat a healthy diet. Although

the mean was strongly positive (M¼5.53 among all student sample), the food features

variable did not have a significant influence. But surprisingly, that was not the case. It is

likely that other factors may after all play a more important role in influencing healthy

diet. HBM has allowed us to understand the comparative influence of various factors.
 20

Given the student lifestyle (Belaski, 2001), preference, and findings reported by

Horacek & Betts (1998) & Marquis (2005), food features were expected to have a strong

influence on healthy eating. But surprisingly, that was not the case. It is likely that other

factors may after all play a more important role in influencing healthy diet.

On the other hand, Kate Louise Perkins’ study on the nutrition knowledge, poor

diet and lack of physical activity has contributed to the obesity epidemic. Heart disease is

now the number one cause of death each year for men and women. About 2/3 of

individuals are overweight or obese, increasing the risk of heart disease and other

complications.

Weight gain is caused by an imbalance of energy intake and output; more calories

consumed than expended. This increase in obesity has also come at a time when the

restaurant industry garners 49% of food dollars and portion sizes are growing larger than

ever. Also, concluded that nutrition education is necessary, especially concerning how

one meal fits into the overall diet. Only 48% of the sample correctly identified the

amount of calories needed daily to maintain weight. It had shown much need for

improvement. It has also concluded that nutrition education is necessary, especially

concerning how one meal fits into the overall diet. Only 48% of the sample correctly

identified the amount of calories needed daily to maintain weight. This shows much need

for improvement.

Finally, the study concluded that health professionals are not better able than

consumers to predict the amount of calories in quick serve food items. They were only

successful with the side item, not the pizza and sandwich. This shows that despite
 21

extensive nutrition knowledge, it is hard to tell how many calories are in restaurant food

items.

According to Vandita Sharma’s study on nutritional status and health, call centers

are of particular concern to health and safety because of the unique type of work

undertaken by the call handler. The industry is touted as a magic wand that will word off

unemployment for thousands of young graduates, presented studies clearly shows that

there is a concern regarding issues of health and safety that are unique to this industry

Sarah Dale Zeola’s pilot study on nutrition-related knowledge

and behaviors of healthcare professionals, Overall, many healthcare

providers were able to accurately estimate their body mass index (BMI)

based on their reported height and weight, though fewer were able to

accurately identify the classification of their BMI using the system put

forth by the National Heart, Lung, and Blood Institute. Less than half of

all professionals surveyed were able to correctly identify both their BMI

and BMI classification. This suggests that there may be some lack of

knowledge on how to calculate a body mass index, BMI classification,

and how a BMI value and classification can be utilized in providing

tailored nutrition messages to clients and patients (2, 3, 8, 14). RDs

had the greatest correlation between their actual and reported BMI

values based on self-reported height and weight, and had the second

greatest correlation between actual and reported BMI classification

behind NPs.
 22

Dietary intake for all healthcare professionals surveyed was less than 56%

congruent with DGA recommendations in all food categories and was lowest for grains

and breads and fats and sweets. It was expected that RDs would have the greatest

congruence between their reported daily intake and the DGA. Of the six food categories,

RDs had the highest congruence in three groups, second highest congruence in two

groups, and third highest congruence in the one remaining group, compared with other

healthcare professionals. Vegetable intake was low among all professional groups, an

outcome similar to reported intake for Americans as a whole (1, 3, 8, 11, 12, 21). Though

dietary intake was not very congruent with the DGA recommendations, RDs displayed

intake more consistent with DGA recommendations than other professionals surveyed.

Meenakshi Mathur, Monika Harsh, and Sumita Mathur’s study on Diet Pattern

and Nutritional Status, At Bangalore call center, maximum women were obese, i.e. 14%

as compared to other cities and at the same time at Mumbai call center, maximum women

were overweight (50%). Most of the participants eat fast food because the life at these

cities is very fast and most of the women were from other cities. 68% of women working

at Noida and 60% of women working in Ahmedabad were of normal weight. This was

because lifestyle of these cities is not very fast most of the women working there were

local residents and stay with their families, as a result they doesn’t eat fast food much and

were conscious towards their health. The finding of the study was supported by Boyee

who determined BMI, weight gain, ergonomics and exercise variables in 395 united

states call center employees. Results demonstrated a substantial weight gain over a period

of 8 months in the participants.

 23

Khushnuma Amin et al study on nutrition knowledge, the attitude and practices, The

data was collected from the Government School Teachers of Rawalpora area regarding

their eating routine and dietary habits and it was concluded that the overall nutritional

status of the respondents was satisfactory. The findings of the present study would be

beneficial and helpful not only to teachers but also to health related workshop to sensitize

society towards maintaining healthy life style. This information would be valuable to

show the way forward for improving the health status of teachers by implementation of

well-designed programs for health and nutrition education and other intervention

measures. In this study majority (42%) of the respondents were in the age group of 40-50

years followed by (28%) who were in the age group 30-40 years and rest of them were in

the age group of 20-30 and 50-60 years of age and majority belongs to the nuclear family.

It was found that 24% of the respondents had monthly income of more than 60,000

followed by 36% of the respondents were having monthly income in the range of 40,000-

50,000 and rest of them showed variations in their monthly income.

The study revealed that majority of the respondents (58%) had not suffered from any

health problem. However (42%) were having some health problems like thyroid,

hypertension, diabetes etc. and were on medication. Half of the respondents felt fatigued

while climbing stairs or doing any heavy activity. 16% of the respondents were anemic. It

was also revealed that 34% of the respondents were overweight and 2% had thin built.

During the research it was revealed that maximum respondents take green leafy

vegetables every day and in their diet pulses, cereals, milk and milk-products is also

included.
 24

As per degree of weight and height on the basis of BMI, it is evident that majority

had normal weight whereas 28% were overweight. Some of the respondents skip their

lunch and they consider their work pattern as the reason for this. Most of the respondents

had a good health and did not suffer from any kind of illness. These respondents also had

a normal level of hemoglobin and most of them had normal range of BMI and the

assessment of the clinical examination revealed that majority of the respondents did not

show any sign of deficiency. Moreover the intake of food stuff by most of the

respondents was quite satisfactory. Even though they had a habit of skipping the meals.

According to Dr. Bernadette Palacio and et al’s study on Eating Attitude and

Behavior, Health Status and Productivity of Personnel, some teachers have risky eating

behavior that warrants referral and further discussion or evaluation of a physician. The

most common lifestyle disease experienced was hypertension followed by diabetes and

osteoporosis, depression, acne, obesity and others warrants further medical or nutritional

intervention. Personnel have experienced varied lifestyle illnesses during the past five

years. There were personnel who were prehypertensive, hypertensive, hypotensive,

overweight, obese or underweight.

In Leticia B. Quisam’s study, majority (70%) of the secondary student

respondents were mildly to moderately undernourished noting a higher incidence among

the females She found out that of the 44 secondary male student respondents, 22 or 50%

belonged to normal nutritional status, 8 were mildly undernourished and 14 were

moderately undernourished. Also, out of the 106 secondary female student respondents
 25

34 belonged are mildly undernourished, 14 are normal and 28 moderately

undernourished.

The study by Mary Antoinette A. Acena dealing with the nutritional and health

status of secondary students, it was revealed that the students are considered to be well-

nourished in spite having poor medical and dental statuses, however a percentage of

62.4% of the total population were considered undernourished therefore needing proper

nourishment. The students’ daily food intake also contains the essential nutrients however

some were not able to have a complete set of meals for a day drawing to a conclusion that

the students lack the necessary nutrients needed for their daily school activities.

On a study on nutritional knowledge and food preferences of tertiary students by

Marlyn A. Villar, the average age for all students was 16.75, for normal and overweight

were 17. There were one hundred forty- nine females who were underweight, forty-

seven overweight and twenty-six normal. For the male, seventy were underweight,

seventeen normal and sixteen overweight. Along the nutritional behavior of the

respondents, meals eaten for breakfast denote food choice being not balanced and it can

be attributed to the schedule of their morning classes. Likewise, with lunch and supper

with the student’s food preference not balanced and even if their snacks contained

carbohydrates, this doesn’t guarantee the nourishment needed by the respondents’ energy

expenditure through-out the day.

Elaine B. Aguilar and Ramon Lorenzo R. Angelo’s study revealed that majority

of the respondents avoids fattening foods and pre-occupied with being thinner. The most

prevalent eating attitude exhibited by the respondents was dieting. The most recurrent
 26

eating behavior seen in the study was binge eating where they felt they might not be able

to stop. But the respondents were at low risk for developing eating disorders.

Ericka Bridget M. Soler and Bryne Chris A. Jumao’s study shows that age is a

factor that determines the selection of food and the eating time. Majority of the students

prefers to eat dinner while not far behind are the ones who eat breakfast. Eating breakfast

regularly in the teenage years is an important factor in nutrition. It is assumed that during

this period, the nutritional needs of the individual increases because of the increased

growth rate and changes in the body composition associated with puberty. Other factors

include quest for independence and acceptance by peers, increased mobility and greater

time spent at school or work and pre- occupation with self- image contributed to the

erratic and unhealthy eating behaviors which are common during adolescence.

Cherrylen V. Nabo’s study that focused on the academic performance of secondary

students in relation to the academic performance, majority of the students are normal in

terms of nutritional status garnering 65 out of 97 garnering the top rank among the the

different classification and was followed by below normal students at 21.65%. The

lowest rank was above normal with only 11 out of 97 students. Therefore

Synthesis of the Art

The in-depth review of the related literature and studies are intended to add

enlightenment to the researcher. The various studies have in one way or another shown

relationship to the proposed study in terms of objective, research methodology and

instrumentations. In addition, the reading of the related literature and studies will help the
 27

research in arriving at a conclusion that will present the best outcome of the study which

is to create awareness on the importance of the nutritional status and practices among

health care providers, clinical instructors and student nurses.

In the literature cited, it can be seen that it is an utmost importance that nutrition does

play a major role in an individual’s general health. Poor eating habits tend to increase

declining function of the body and organs especially the brain, heart and kidney. The

effects from poor nutrition are seemingly endless. It generally results in considerable

weight gain, which puts a person at risk for a myriad of health problems, whether

physical, mental or emotional. It also emphasizes that it is deemed important to not only

care for clients’ and patients’ health but also to one’s self. Stroke, diabetes, heart

problems, obesity, malnutrition, eating disorders are but the major problems with regards

to nutrition.

The same generalization can be formulated for the related studies. In addition,

there were related topics from the gathered researches from Acena; Dr. Palacio et al,

Sameer Deshpande et al, James, Quisam, and Kinyua presented another perspective in

health and nutrition. The outcome of the mentioned papers were about increasing

awareness and practicing good nutritional health and the increase of health-related threats

to students as well as professionals. Knowing one’s nutritional status and practices can be

helpful in the development of nutritional consciousness but the intensity of its effect is

unknown. However, recent studies show that a lot of factors affect the way we eat. For

instance, during the adolescent stage, the popular belief is that being thin is better than

being fat causing teens to develop eating disorders just to be considered part of the group.
 28

Ericka Bridget M. Soler and Bryne Chris A. Jumao’s study shows that age does

play an important part in the individual’s eating time and habits. As we grow, the

nutritional needs of a person changes thus making it very difficult to estimate the

nutrients of the food. The ideal time people should eat is three times a day but due to the

factors like financial matters, schedules and what one would like to eat, some people eat

twice a day or only once thus developing possible diseases, especially eating disorders.

Gaps to be Bridged by the Study

Both foreign and local studies reviewed are considered related in the undertaking

and delved more on the nutritional status of children, other professionals and college

students. There were studies about dietary practices, health and nutrition status,

misconceptions about health and food selection and a study closely related in assessing

the dietary practices and attitudes and behaviors of student nurses of Bicol University

College of Nursing, Legazpi City that focused on the possible eating disorders of the

respondents. There are no studies yet that tackled on the nutritional status and practices of

the clinical instructors together with the students about nutrition status and making this

present study different from previous studies reviewed. This is the gap bridged by this

study.

Theoretical Framework

The Health Promotion Model was proposed by Nola J. Pender was designed to be a

complementary counterpart to models of health protection. It defined health as a positive

dynamic state not merely the absence of disease. Health promotion is defined as behavior
 29

motivated by the desire to increase well-being and actualize human health potential. It is

an approach to wellness and it describes the multi-dimensional nature of person as they

interact within their environment to pursue health. Health promotion is the science and

art of helping people change their lifestyle to move toward a state of optimal health.

The health promotion model notes that each person has unique personal

characteristics and experiences that affect subsequent actions. The set of variables for

behavioral specific knowledge and affect have important motivational significance. These

variables can be modified through nursing actions. Health promoting behavior is the

desired behavioral outcome and is the end point in the HPM. Health promoting behaviors

should result in improved health, enhanced functional ability and better quality of life at

all stages of development. The final behavioral demand is also influenced by the

immediate competing demand and preferences, which can derail an intended health

promoting actions.

Pender’s model focuses on the three areas: individual characteristics and

experiences, behavior-specific cognitions and affect, and behavioral outcomes. The major

concepts and definition of the health promotion model are individual characteristics and

experience, prior related behavior, and frequent of the similar behaviour in the past.

Health-promoting behavior is the endpoint or action outcome directed toward

attaining a positive health outcome such as optimal well-being, personal fulfillment, and

productive living. Due to its focus to health promotion and disease prevention, its

relevance to nursing actions given to individuals who are ill are obscure. But then again,

this characteristic of her model also gives the concepts its uniqueness. Pender’s principles
 30

paved a new way of viewing nursing care but then one should also be reminded that the

curative aspect of nursing cannot be detached from our practice.

Individual Behavior Specific

Characteristics
Cognition and Affect Behavioral Outcome
and Experiences

PERCEIVED BENEFITS OF
ACTION

PERCEIVED BARRIERS TO
ACTION

PERCEIVED
SELF-EFFICACY
Prior Related
Behavior

ACTIVITY IMMEDIATE
RELATED AFFECT COMPETING
DEMANDS
(low control)
and
PREFERENCES
(high control)

COMMITMENT HEALTH
PERSONAL FACTORS: TO A PLAN OF PROMOTINIG
Biological, ACTION BEHAVIOR
Psychosocial,
Socio-cultural INTRAPERSONAL INFLUENCES
(Families, Peers, Providers);
Norms, Support, Models

SITUATIONAL INFLUENCES
Options, Demands,
Characteristics, Aesthetics
 31

Figure 1. Theoretical Paradigm of the Study

 31

Conceptual Framework

The conceptual framework showed in follows the input, process and output

system. In this study, which is to determine and discover the interrelationship between

those variables which is the significance relationship between the nutritional practices of

the clinical instructors and students based from IEC (Information, Education and

Communication) as a guide to Good Nutritional Health.

The input of the study contains the characteristics of nurses, including the

students and clinical instructors. The need of the students as well as clinical instructors to

be aware on how they can manage to maintain the proper nutrients needed by the body.

The proper knowledge and being aware of the importance of proper nutrition as one of

the important aspect of life, will help to remain healthy, to be physically prepared and to

lead a healthy life.

The process consists of food source, eating habits and food intake of the

respondents. In every individual possesses a different eating attitudes and behaviors in

which they can engage in results either to a healthy or unhealthy outcome. Some students

as well as clinical instructors are not familiar with healthy foods needed for their body in

different conditions. The output considered in the study is the IEC material that can

developed to guide the respondents on how to have a good nutritional health. Eating a

balance and good diet will help to fight for any illnesses as well as to have a good and

better life in the future. It is obvious that this requires a detailed plan, the implementation

of, which needs to be properly evaluated.

 32

Characteristic Profile

A. Student
 Age
 Sex
 Religion
 Average monthly income of parents
 Average weekly allowance?
 Body Mass Index
 Living arrangement
 Nutritional related illnesses

B. Clinical Instructors
 Age
 Sex
 Civil status
 Religion
 Average Monthly Income
 Body Mass Index
 Nutritional related illness

Nutritional Practices
A. Food intake
B. Food sources
C. Eating habits

Development of IEC
material as a guide to
Good Nutritional Health.

Figure 2. Conceptual Paradigm of the Study

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DEFINITION OF TERMS

For better understanding of the study the following terms were defined conceptually

and/or operationally.

Nutrition. It is the study of food in relation to the health of an individual,

community or society and the process through which food is used to sustain life and

growth. In this study, it is the process by which a living organism assimilates food and

uses it for growth and development

Nutrition Status. Nutritional is the balance between the intake of nutrients by an

organism and the expenditure of this in the processes of growth reproduction and health

maintenance. It refers to the weight, height and usual food intake of the respondents.

Operationally, it is a condition in which the body relates to consumption and utilization

of nutrients in relation of food.

Nutritional Practice. In this study, it described the nutritional practice of students

and clinical instructors in terms of their food intake, food source and eating habits to

maintain nutritional balance that is needed by the body to provide energy and for growth

as well.

Body Mass Index. It is a key index of relating a person’s weight to their height.

The BMI is a person’s weight in kilograms (kg) divided by their height in meters squared

(m2). It determines whether a person is under or overweight.

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Food. Defined as any substance, whether processed, semi-processed or raw this

is intended for human consumption and including beverages, chewing gum and any

substance. Anything that can be eaten and is an essential to everyday living.

Food Intake. The substance in which our body needed to provide energy and

consisting of carbohydrates, proteins, fats, vitamins and minerals. It is what we eat daily.

In which a person need for energy and to allow for growth. For humans, eating is an

activity of daily living.

Food Source. In which plants, meat and sea-foods are the origin. It is where the

food comes from. In which the respondents get the nutrients needed by the body. It is any

substance consumed to provide nutritional support for the body.

Eating Habits. It refers to what people eat or what kind of food they eat, which

food they eat, and with whom they eat. It also refers to the routine of a person, on what

they prefer to eat in everyday living.

Good Nutritional Health. The ability of the body to promote and prevent

diseases. In which a person is mentally and physically alert, well developed body and

ideal weight for body composition.

Evaluation. Ongoing activities that determine and support management

accountability, effectiveness, and efficiency. Determine the significance or worth or

condition of usually by careful appraisal and study

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Nutritional Analysis. A process that determine the nutritional content of food or

food products. A determinant in which an individual can see if he/she is eating the right

and nutrient base food.

Nutritional Assessment. The evaluation of nutritional status. Gather

information in which to make professional judgment about nutritional status. A data of an

individual in which the researcher collect, organize and evaluate the nutritional status.

Nutritional Evaluation. the evaluation of nutritional status. Gather information

in which to make professional judgment about nutritional status. The use of instrument

such as questionnaires in which the researchers gather the information from the

respondents, to make the professional judgment.

Nutritional Value. Defines what a food is made of, means the quantity range, and

quality energy and its' impact on the body. It determines how nutritious the food is. A

compliance of daily requirement.

Nutritional Problems. It is an obstacle or a challenge to be solve within a period

of time. The main focus of this study which is to be answered. Common nutritional

problem includes malnutrition, obesity, hypertension, diabetes, and other common

nutritional problems.
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NOTES

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Azizi, M., Aghaee, N., Ebrahimi, M., & Ranjbar, K. (2011). NUTRITION
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Pioneer Thinking. (n.d.). Brain Research Shows: Diet and Exercise are Keys to Living
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Satran, J. (2012, December 30). Trans Fats-Brain Damage Link Suggested By New Study
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